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April 1968

The Laryngeal Cartilages: Physiologic Nonmineralization Masquerading Malignant Destruction

Arch Otolaryngol. 1968;87(4):416-421. doi:10.1001/archotol.1968.00760060418016

THE NORMAL laryngeal cartilages can tolerate cancerocidal doses of radiation,1 but cartilage that has been eroded by a tumor is likely to respond to this treatment with massive necrosis.2-4 Inasmuch as this complication itself frequently requires a laryngectomy, initial surgery is superior to irradiation when there is cartilage involvement. Since this involvement may determine the treatment of choice, its presence or absence should be ascertained before definite therapy is instituted.

The clinical signs associated with cartilage destruction may be meager or absent, and definite diagnosis must depend on radiographic evidence. However, more than 50 years after Iglauer's report on radiography of the larynx5 the evaluation of suspected cartilaginous destruction can tax the ingenuity of the most astute observer. Baclesse formulated criteria for radiographic diagnosis of cartilage involvement by malignant tumors of the larynx.6 These criteria may be briefly summarized as follows: (1) Supraglottic tumors produce a